General Surgery Department, Unidade Local de Saúde do Tâmega e Sousa, Penafiel, Portugal.
Angiology and Vascular Surgery Department, Unidade Local de Saúde de São João, Porto, Portugal.
Hernia. 2024 Aug;28(4):1005-1015. doi: 10.1007/s10029-024-03018-8. Epub 2024 Mar 24.
Laparoscopic groin hernia repair has evolved and gained popularity and laparoscopic transabdominal preperitoneal (TAPP) procedure provides an opportunity to evaluate the peritoneal cavity and both inguinal areas without the need for additional dissection. There is still a paucity of evidence to support TAPP repair in the emergency setting. In this systematic review, we aim to evaluate the feasibility and safety of TAPP repair for incarcerated and strangulated groin hernias.
PRISMA guidelines were followed for literature search and established inclusion and exclusion criteria were applied. Data were extracted and analyzed for the outcomes of interest.
Overall, 8 studies were included in the review, comprising 316 patients. Patients characteristics and outcomes were limitedly reported. Only 3 cases of conversion to open approach were reported and 2 recurrences were diagnosed. Postoperative complications are inconsistently reported but mostly refer to minor complications. There were no mortality cases. Visceral resections were performed in 25 cases due to ischemia, mostly extracorporeally.
Laparoscopy is a game changer and TAPP approach is a feasible, safe, and effective technique for the emergent repair of groin hernias. Further studies and prospective randomized data are needed to establish its role in the emergent groin hernia management.
腹腔镜腹股沟疝修补术已经发展并得到普及，腹腔镜经腹腹膜前（TAPP）手术为评估腹腔和双侧腹股沟区域提供了机会，而无需进行额外的解剖。目前仍缺乏支持 TAPP 手术在紧急情况下应用的证据。在本系统评价中，我们旨在评估 TAPP 修复嵌顿性和绞窄性腹股沟疝的可行性和安全性。
我们遵循 PRISMA 指南进行文献检索，并应用既定的纳入和排除标准。对感兴趣的结局进行数据提取和分析。
总体而言，该研究纳入了 8 项研究，共 316 例患者。患者特征和结局的报告有限。仅报告了 3 例转为开放手术的病例和 2 例复发的病例。术后并发症的报告不一致，但大多为轻微并发症。无死亡病例。由于缺血，25 例患者行内脏切除术，大多为体外进行。
腹腔镜技术是一种变革性的方法，TAPP 入路是一种可行、安全且有效的紧急腹股沟疝修补技术。需要进一步的研究和前瞻性随机数据来确定其在紧急腹股沟疝管理中的作用。
